The HandTutor–Vital Tool in Physical Rehabilitation Post Spinal Cord Injury

Lisa A Harvey, Sarah A Dunlop, Leonid Churilov, Ya-Seng Arthur Hsueh and Mary P Galea writing for SPRINGER LINK.COM discuss a study about loss of hand function as being one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation.Armtutor Brain Injury, cerebral palsy, functional task practice, handtutor, hip, knee, leggtutor, Neurorehabilitation, occupational therapy, physiotherapy, SCI, stroke, Surgery

The methods/design of a multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete) undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009.The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation.
The newly developed HandTutor has become a vital tool in spinal cord and brain injury rehabilitation.
The HandTutor™ system is an active exercise based hand rehabilitation program that uses the accepted methods of impairment oriented training (IOT) with augmented feedback. The HandTutor™ evaluates and treats finger and hand movement dysfunction through exercises that encourage extension/ flexion of the finger(s) and wrist.
The HandTutor™ consists of a safe comfortable glove, with position and speed sensors that precisely record finger and wrist motion, and dedicated rehabilitation software. The ergonomic gloves come in five sizes for both right and left hands. The rehabilitation system, which includes the ArmTutor, LegTutor and 3DTutor, employs the known concept of biofeedback to give occupational and physical therapists access to an affordable user friendly hand rehabilitation package. The HandTutor™ can also be used in combination with the 3DTutor™ for arm rehabilitation. The HandTutor™ is CE medical and FDA certified. See www.HandTutor.com for more information.